Individual provider Active NPI

Jessica J Michel, PT, ATC, CSCS

  • Physical Therapist
  • Sunbury, OH
National Provider Identifier
1427336452
Registry record updated Jul 28, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT.013333 Issued in OH
Practice address
700 W Cherry St
Suite B
Sunbury, OH 43074-8011
Phone
(740) 936-4944
Fax
(740) 936-0251
NPI assigned
Jul 25, 2011
Last updated
Jul 28, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 28, 2017

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT.013333 OH Primary
Athletic Trainer 2255A2300X AT.003269 OH

Addresses

Primary practice location

700 W Cherry St
Suite B
Sunbury, OH 43074-8011

Mailing address

625 Enterprise Dr
Oak Brook, IL 60523-8813
Phone (630) 575-1980

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110824000887 OH Practitioner - Physical Therapist in Private Practice 3870763139 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Athletico LTDGroup PAC ID 4789602681, 2,187 clinicians

Practice addresses (Care Compare)

120 N Miller Dr
Suite B
Sunbury, OH 43074-7630
Phone (740) 936-4944

Merit-based Incentive Payment System (MIPS)

Final score
86.32 of 100Reported as group
Quality
84.44
Promoting interoperability
99
Improvement activities
40
Cost
70.78

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT.013333OHMDPhysical Therapist
AT.003269OHMDAthletic Trainer

Practice roles

OrganizationSpecialtyStatusNew patients
Athletico LTD Physical Therapist CurrentSince Jun 1, 2020 Accepting new patients
Athletico LTD Physical Therapist CurrentSince Jun 1, 2020 Accepting new patients
Burkam & Associates, LLC Past Accepting new patients

Locations

625 Enterprise Dr
Oak Brook, IL 60523
Phone (630) 575-6250

323 N Breiel Blvd
Middletown, OH 45042
Phone (513) 420-1700

4925 Jackman Rd
Ste 34
Toledo, OH 43613
Phone (567) 318-1000

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1311552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1501200000000",
    "number": "1427336452",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "625 ENTERPRISE DR",
            "city": "OAK BROOK",
            "state": "IL",
            "postal_code": "605238813",
            "telephone_number": "630-575-1980"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 W CHERRY ST",
            "address_2": "SUITE B",
            "city": "SUNBURY",
            "state": "OH",
            "postal_code": "430748011",
            "telephone_number": "740-936-4944",
            "fax_number": "740-936-0251"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MICHEL",
        "first_name": "JESSICA",
        "middle_name": "J",
        "name_prefix": "Ms.",
        "credential": "PT, ATC, CSCS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-07-25",
        "last_updated": "2017-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OH",
            "license": "PT.013333",
            "primary": true
        },
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "OH",
            "license": "AT.003269",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sunbury, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.